Vermont has been ranked as the healthiest state, according to the United Health Foundation. / Toby Talbot, AP

by Michelle Healy, USA TODAY

by Michelle Healy, USA TODAY

Americans are living longer, with fewer deaths from heart disease and cancer, but more chronic illnesses, an annual snapshot of the USA's health shows.

The 2012 America's Health Rankings highlight troubling levels of obesity, diabetes, high blood pressure and sedentary behavior. Medical advances are allowing more people to live with those conditions.

The bottom line: Americans "are living longer, sicker" with more chronic illness, says Reed Tuckson of theUnited Health Foundation, a not-for-profit foundation that sponsors the report with the American Public Health Association and the Partnership for Prevention.

For the sixth consecutive year, Vermont tops the list of healthiest states, says the report, which uses data from the Centers for Disease Control and Prevention, American Medical Association, Census Bureau and even the FBI. It looks at 24 measures of health, including tobacco and alcohol abuse, exercise, infectious diseases, crime rates, public health funding, access to immunizations, premature birth rates and cancer and heart disease rates.

States that are most successful on the rankings "have good results in a majority of the conditions we evaluate," Tuckson says. But states such as Mississippi and Louisiana, which tied for last place, "are over represented in key measures like tobacco consumption, lack of exercise and obesity - the fundamentals," he adds.

Although socioeconomic factors play an important role in some states' consistent low rankings, "we know it is possible to improve; states are capable of doing that," says Georges Benjamin, executive director of the American Public Health Association. Key to that effort is "taking lessons from things they do well and applying them more vigorously to the things they are not doing well."

Louisiana has low rates of binge drinking and a high rate of childhood immunization, but it ranks in the bottom five states on 13 of 24 health measures, including obesity and diabetes.

But "we don't have to accept those" indicators, says Karen DeSalvo, health commissioner for New Orleans. She says an extensive effort is underway "to get us to the place we need to be â?¦ to be a healthy state."

States that showed the most substantial improvement in rankings include New Jersey (up nine places on the list); Maryland (up five). Alabama, Colorado, Massachusetts, Nebraska, Oklahoma, and Rhode Island each moved up three.

Among the unhealthy behaviors the report cites:

More than a quarter (26.2%) of all Americans are sedentary, defined as not doing any physical activity outside of work for 30 days. But it's 36% in Mississippi, and 35.1% in both Tennessee and West Virginia.

27.8% of U.S. adults are obese, defined as being roughly 30 or more pounds over a healthy weight. That's 66 million people - more than the entire population of the United Kingdom. In even the least obese state, Colorado, more than 20% of the population is obese.

The percentage of adults with diabetes is 9.5% nationally, but it's 12% or higher in West Virginia, South Carolina and Mississippi.

30.8% of U.S. adults have high blood pressure, but that ranges from a low of 22.9% in Utah to a high of 40.1% in Alabama. High blood pressure, or hypertension, is a primary risk for cardiovascular disease - problems related to the heart and the blood vessels.

"There's no way that this country can possibly afford the medical care costs and consequences of these preventable chronic illnesses," says Tuckson. "We have two freight trains headed directly into each other unless we take action now."

"People have to be successful at taking accountability for their own health-related decisions."

Life expectancy in the USA is now 78.5 years; premature deaths have dropped 18% since 1990, and deaths from cardiovascular disease are down 34.6%. Cancer deaths are down 7.6%.